County-level prohibition and alcohol-related fatal motor vehicle accidents

The 50 states and the District of Columbia were grouped according to whether or not they had county-level alcohol prohibition. Several motor vehicle fatality rates were calculated for each type of jurisdiction, including the single-vehicle fatality rate (an index of alcohol-related motor vehicle accidents). In all cases, motor vehicle fatality rates for drivers in states with county-level prohibition were significantly greater than in nonprohibition states. This suggests that drivers residing in counties with prohibition are compelled to drive to adjacent counties or states to drink and consequently have increased involvement in motor vehicle accidents.     

Mortality in rural locations after severe injuries from motor vehicle crashes

BackgroundMortality from traffic crashes is often higher in rural regions, and this may be attributable to decreased survival probability after severe injury.MethodsData were obtained from the National Automotive Sampling System – General Estimates System (NASS-GES) for 2002–2008. Using weighted survey logistic regression, three injury outcomes were analyzed: (a) Death overall, (b) Severe injury (incapacitating or fatal), and (c) Death, after severe injury. Models controlled for (pre-crash) person, event, and county level factors.ResultsThe sample included 883,473 motorists. Applying weights, this represented a population of 98,411,993. Only 2% of the weighted sample sustained a severe injury, and 9% of these severely injured motorists died. The probability of death overall and the probability of severe injury increased with older age, safety belt nonuse, vehicle damage, high speed, and early morning crashes . Males were less likely to be severely injured, but more likely to die if severely injured. Motorists in southern states were more likely to have severe injuries, but not more likely to die if severely injured. Motorists who crashed in very rural counties were significantly more likely to die overall, and were more likely to die if severely injured.ConclusionsMotorists with severe injury are more likely to die in rural areas, after controlling for person- and event-specific factors.     

Analysis of injury mechanism of the elderly and non-elderly groups in minor motor vehicle accidents

Abstract

Objective: The purpose of this study is to investigate the injury patterns of noncatastrophic accidents by individual age groups.

Methods: Data were collected from the Korean In-Depth Accident Study database based on actual accident investigation. The noncatastrophic criteria were classified according to U.S. experts from the Centers for Disease Control and Prevention’s recommendations for field triage guidelines of high-risk automobile crash criteria by vehicle intrusions more than 12 in. on occupant sites (including the roof) and more than 18 in. on any site. The Abbreviated Injury Scale (AIS) was used to determine injury patterns for each body region. Severely injured patients were classified as Maximum Abbreviated Injury Scale (MAIS) 3 or higher.

Results: In this study, the most significant injury regions were the head and neck, extremities, and thorax. In addition, the incidence of severe injury among elderly patients was nearly 1.6 times higher than that of non-elderly patients. According to age group, injured body regions among the elderly were the thorax, head and neck, and extremities, in that order. For the non-elderly groups, these were head and neck, extremities, and thorax. Severe injury rates were slightly different for the elderly group (head and neck, abdomen) and non-elderly group (thorax, head and neck).

Conclusions: In both age groups, the rate of severe injury is proportional to an increase in crush extent zone. Front airbag deployment may have a relatively significant relationship to severe injuries.     

Functional outcomes of motor vehicle crash thoracic injuries in pediatric and adult occupants

Objective: Characterization of the severity of injury should account for both mortality and disability. The objective of this study was to develop a disability metric for thoracic injuries in motor vehicle crashes (MVCs) and compare the functional outcomes between the pediatric and adult populations.

Methods: Disability risk (DR) was quantified using Functional Independence Measure (FIM) scores within the National Trauma Data Bank for the most frequently occurring Abbreviated Injury Scale (AIS) 2–5 thoracic injuries. Occupants with thoracic injury were classified as disabled or not disabled based on the FIM scale, and comparisons were made between the following age groups: pediatric, adult, middle-aged, and older occupants (ages 7–18, 19–45, 46–65, and 66+, respectively). For each age group, DR was calculated by dividing the number of patients who were disabled and sustained a given injury by the number of patients who sustained a given injury. To account for the effect of higher severity co-injuries, a maximum AIS adjusted DR (DR_MAIS) was also calculated for each injury. DR and DR_MAIS could range from 0 to 100% disability risk.

Results: The mean DR_MAIS for MVC thoracic injuries was 20% for pediatric occupants, 22% for adults, 29% for middle-aged adults, and 43% for older adults. Older adults possessed higher DR_MAIS values for diaphragm laceration/rupture, heart laceration, hemo/pneumothorax, lung contusion/laceration, and rib and sternum fracture compared to the other age groups. The pediatric population possessed a higher DR_MAIS value for flail chest compared to the other age groups.

Conclusion: Older adults had significantly greater overall disability than each of the other age groups for thoracic injuries. The developed disability metrics are important in quantifying the significant burden of injuries and loss of quality life years. Such metrics can be used to better characterize severity of injury and further the understanding of age-related differences in injury outcomes, which can influence future age-specific modifications to AIS.     

The relationship of beer consumption and state alcohol and motor vehicle policies to fatal accidents

Fatal accident data from 50 states and the District of Columbia were examined in order to determine the relationship between alcohol availability and fatal motor vehicle accidents. This relationship was analyzed for both fatal accidents and motor vehicle fatalities (potentially more than one per accident) using multiple regression. The independent variables were: (1) driving age (percent of drivers under 21); (2) beverage purchase age; (3) average beer consumption; (4) number of outlets per million population selling alcohol for on-premise consumption; (5) percentage of metropolitan residents; (6) percentage of male drivers; and (7) mileage per driver per year. It was found that the regression analyses for fatal accidents and for fatalities were highly similar. Driving age was the strongest predictor of highway mortality. On-premise availability of alcohol was significantly and inversely associated with motor vehicle fatalities. This suggests that when on-premise outlets are fewer and more geographically spread out, the chances of drinking and driving are greater. Finally, average beer consumption was significantly and positively associated with highway fatalities perhaps because many drivers consider it a “soft” alcoholic beverage that will not impair their ability to drive.     

Assessment of medical care costs of injuries due to alcohol-related motor vehicle crashes

The purpose of this study was to estimate the total medical care costs of individuals injured in motor vehicle crashes and in crashes where alcohol was involved. Crashes were studied that involved 2,728 vehicle occupants and 191 pedestrians with injuries as reported in 1979 by the National Accident Sampling System, a probability sample of all motor vehicle crashes occurring in the united States. Medical care costs were assigned by using Abbreviated Injury Scale codes in accordance with other published research. Determination of alcohol involvement was based on crash characteristics. Results indicate that 20.2 % of medical care costs for motor vehicle crash injuries may be due to crashes where alcohol was involved. It was estimated that alcohol-related motor vehicle crashes cost between $434 million and $483 million in medical care alone in the United States in 1979.     

Predictors of motor vehicle collision injuries among a nationally representative sample of Canadians

OBJECTIVE: The purpose of this study was to examine predictors of subsequent motor vehicle collision injuries, with a particular focus on health-related variables, using the longitudinal dataset from the Canadian National Population Health Survey (NPHS) for the years 1994-2002. METHODS: Multiple logistic regression analysis was used to determine the relations between motor vehicle collision injury and four risk factors: binge drinking, health status, distress, and medication use. Age and sex were included as control variables. The total sample size was 14,529. RESULTS: A higher percentage of females and younger persons reported a motor vehicle collision injury. Binge drinkers, respondents with poor health, respondents with distress, and respondents reported using two or more medications reported a higher percentage of subsequent injuries. Logistic regression analysis found that persons with poorer health status and persons who used more medications had higher odds of motor vehicle injuries. Only one statistically significant interaction effect was found: alcohol bingeing and medication use. CONCLUSIONS: Among a nationally representative sample of Canadians, various demographic and risk factors predict subsequent injuries. Given that this number represents a considerable economic burden, this study underscores the need for continued research and countermeasures on alcohol, drugs, and driving.     

Coverage of motor vehicle crashes with injuries in U.S. newspapers, 1999-2002

Problem

The aims of the study were to evaluate information on motor-vehicle crashes with injuries provided in newspaper reports and to assess the frequency of thematic and episodic reporting of motor-vehicle crashes.

Method

The study used Fatal Analysis Reporting System (FARS) derived variables to code a nationally representative sample of U.S. newspaper reports of motor-vehicle crashes from 1999-2002. A total of 473 newspaper reports of motor-vehicle crashes with injuries were included. Information on the crash event, people involved, and vehicles was extracted. The reports were coded for episodic and thematic news framing.

Results

A majority of newspaper reports used episodic framing. The majority of reports included information on the type of crash, but characteristics about people and vehicles were rarely reported.

Discussion

Lack of information in newspapers makes them an incomplete source from which to influence public perceptions and attitudes.

Impact on industry

This provides an opportunity for news print media to improve public health content.

Impact on industry

Newspapers represent an important source of public information; they are, however, an incomplete source [Voight, B., Lapidus, G., Zavoski, R., & Banco, L. (1998). Injury reporting in Connecticut newspapers. Injury Prevention, 4, 292-294.; Baullinger, J., Quan, L., Bennett, E., Cummings, P., & Williams, K. (2001). Use of Washington state newspaper for submersion injury surveillance. Injury Prevention, 7, 339-342]. To increase the accuracy of information provided to the public through media sources, there is a need for increased communication between public health professionals and reporters.The results of this study raise concerns about the contents of motor-vehicle crash information provided in newspapers and suggest that newspapers do not provide information to allow public perception to be in accord with the importance of motor-vehicle crash injuries and health promoting actions to reduce risk of injury. More balanced and detailed information in newspapers would provide an opportunity for news print media to improve public health programs and public perception about the impact of motor-vehicle crashes on safety for all.     

论伤亡事故的必然性与偶然性

通过分析伤亡事故的外在表现形式和内在本质规律,揭示了伤亡事故的偶然性与必然性的辩证关系,透过现象看本质,从中找出故事的危险因素,并做好预防事故的转化工作。     

Child passengers injured in motor vehicle crashes

IntroductionDuring 2010, 171,000 children aged 0–14 were injured in motor vehicle crashes. Despite the severity of the problem, research has been limited, and most of what we know about these children emanates from fatal crash databases.MethodUsing information from the General Estimates System, this effort examines the occurrence of non-fatal crashes among children aged 0–14 over the last decade.ResultsWe found that about 1% of the non-injured children in the file had been driven by a driver who was positive for alcohol. This percentage climbed to about 2% among children who had suffered injuries. Compared with the proportion of alcohol-positive drivers at the time of the crash, the proportion of drivers who sped or failed to obey a traffic signal was significantly higher.Practical applicationsThe finding that drinking and driving with children did not decrease over time questions the adequacy of the extant child endangerment laws.     

Driver's alcohol and passenger's death in motor vehicle crashes

OBJECTIVE: Previous studies on alcohol involvement associated with fatal injury in traffic crashes have focused on the drivers, but the passenger's view is not well known. This study (1) analyzes the relationship between passenger's death and alcohol inebriation of the driver and (2) estimates the role of alcohol as the cause of a crash by examining who was at fault, sober, or inebriated. METHOD: The study includes all motor vehicle passengers (n = 420) who died in crashes in Sweden 1993 through 1996 and were medicolegally autopsied. Autopsy reports from the Departments of Forensic Medicine, including toxicological analyses, and police reports were studied. Presence of alcohol among drivers was based on blood and breath tests. RESULTS: One-fifth of the fatally injured passengers and one-fifth of the tested drivers were under the influence of alcohol. The youngest drivers had the highest prevalence of drunken driving. Drivers at fault were alcohol positive in 21% of these crashes and drivers were not at fault in 2% of these crashes. In 53% of the crashes where both the passenger and driver were alcohol positive, the passenger had a lower alcohol concentration than the driver. Children (<16 years) comprised 15% of the killed passengers. Notably, the children were riding with a driver who was under influence of alcohol in 13% of these crashes. Alcohol involvement was not tested in half of the surviving drivers. CONCLUSIONS: The data show that 20% of both passengers and drivers were under the influence of alcohol. Increased testing of surviving drivers regarding alcohol and other drugs is recommended.     

Impact of medical fitness to drive policies in preventing property damage,injury, and death from motor vehicle collisions in Ontario,Canada

Introduction: Drivers with medical conditions and functional impairments are at increased collision risk. A challenge lies in identifying the point at which such risk becomes unacceptable to society and requires mitigating measures. This study models the road safety impact of medical fitness-to-drive policy in Ontario. Method: Using data from 2005 to 2014, we estimated the losses to road safety incurred during the time medically-at-risk drivers were under review, as well as the savings to road safety accrued as a result of licensing decisions made after the review process. Results: While under review, drivers with medical conditions had an age- and sex-standardized collision rate no different from the general driver population, suggesting no road safety losses occurred (RR = 1.02; 95% CI: 0.93–1.12). Licensing decisions were estimated to have subsequently prevented 1,211 (95% CI: 780–1,730) collisions, indicating net road safety savings resulting from medical fitness to drive policies. However, more collisions occurred than were prevented for drivers with musculoskeletal disorders, sleep apnea, and diabetes. We theorize on these findings and discuss its multiple implications. Conclusions: Minimizing the impact of medical conditions on collision occurrence requires robust policies that balance fairness and safety. It is dependent on efforts by academic researchers (who study fitness to drive); policymakers (who set driver medical standards); licensing authorities (who make licensing decisions under such standards); and clinicians (who counsel patients on their driving risk and liaise with licensing authorities). Practical Applications: Further efforts are needed to improve understanding of the effects of medical conditions on collision risk, especially for the identified conditions and combinations of conditions. Results reinforce the value of optimizing the processes by which information is solicited from physicians in order to better assess the functional impact of drivers’ medical conditions on driving and to take suitable licensing action.     

机动车尾气污染及防治对策研究

汽车是当今社会中人们最重要的代步工具,在人们的日常生活中占据着不可替代的位置。随着我国经济快速发展,城市机动车数量不断增加,导致尾气污染问题也日益严重,这不仅对大气质量造成了不良影响,同时也严重危害到了人们的身体健康。因此,机动车尾气污染问题必须得到有关部门高度重视,并且结合造成污染加剧的主要原因,找到机动车尾气污染防治的有效对策。本文将针对机动车尾气污染危害及防治对策进行分析。